NPIMap

Organization Active NPI

Carmen Cermira Rivera Marcano

Doing business as Laboratorio Clinico Y Bacteriologico Licer

  • Clinical Medical Laboratory
  • San Lorenzo, PR
National Provider Identifier
1306967336
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CARMEN CERMIRA RIVERA MARCANO
Doing business as
Laboratorio Clinico Y Bacteriologico Licer
Practice address
Plaza Buxo Munoz Rivera 216
Suite 2
San Lorenzo, PR 00754
Phone
(787) 715-1895
Fax
(787) 715-0655
NPI assigned
Apr 3, 2007
Last updated
Mar 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carmen Cermira Rivera Marcano
Title
Owner
Phone
(787) 715-1895

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

Plaza Buxo Munoz Rivera 216
Suite 2
San Lorenzo, PR 00754

Mailing address

Plaza Buxo Munoz Rivera 216
Suite 2
San Lorenzo, PR 00754
Phone (787) 715-1895

Other names 1

  • Laboratorio Clinico Y Bacteriologico Licer Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051004000741 PR Part B Supplier - Independent Clinical Laboratory 9638109887 Practice locations: San Lorenzo, PR

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Laboratorio Clin Licer4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395100800000",
    "number": "1306967336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PLAZA BUXO MUNOZ RIVERA 216",
            "address_2": "SUITE 2",
            "city": "SAN LORENZO",
            "state": "PR",
            "postal_code": "00754",
            "telephone_number": "787-715-1895",
            "fax_number": "787-715-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PLAZA BUXO MUNOZ RIVERA 216",
            "address_2": "SUITE 2",
            "city": "SAN LORENZO",
            "state": "PR",
            "postal_code": "00754",
            "telephone_number": "787-715-1895",
            "fax_number": "787-715-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARMEN CERMIRA RIVERA MARCANO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2014-03-18",
        "status": "A",
        "authorized_official_last_name": "RIVERA MARCANO",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "CERMIRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-715-1895"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratorio Clinico Y Bacteriologico Licer",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Lorenzo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.